Dr. Phelps, I have been diagnosed with bipolar II and ADHD. I'm a 62
year old male and 2 years ago, I had my testosterone level checked due to low
libido and it was dramatically low so my GP figured that it could help with my
depression. So he put me on 240 mgs of Andriol caps daily. I would like to know
if it could affect moods? Thank you

Dear Robert
--
Two thoughts on this. First, we have no data on the significance of
testosterone levels at any age relative to mood. Is it really true, we should
ask, whether low testosterone levels are associated with depression?

I wasn't
sure about that answer, so I took a look at the national Library of medicine
database. A recent review linked the testosterone deficiency and depression.Tostain But another equally recent pair of reviews disputed the link.
Amiaz,
Ebinger The language of
the latter two reviews sounds more authoritative to me, more broad in view (just
based on the abstract). For now, I think we could conclude that the link
between testosterone deficiency and depression is not clearly established, but
that there may indeed be some men in whom low testosterone levels are a
contributor to depression.

Of course
the next question is whether anyone has clearly shown that giving testosterone
can improve depression. Another recent review of that issue raises doubt, but
again notes that it may be possible that some men, particularly older men, with
low testosterone levels, may see mood benefit from testosterone treatment.Kanayama

And then
finally, we come to the most pertinent question (my second thought): do we have
any reason to be concerned that testosterone treatment for depression in Bipolar
II might have more negative effects then the same treatment might cause in
people with (unipolar) "major depression"? Unfortunately, the answer here is
similarly foggy. Certainly we know that other steroid hormones can make bipolar
disorder wars, namely prednisone, for example when it is given for asthma, or
poison oak. Likewise we also know that another pair of steering hormones,
estrogen and progesterone, are clearly involved in shifts in mood -- not just
"PMS", but worsening of mood symptoms after childbirth, so-called postpartum
depression; worsening of mood symptoms at perimenopause; and even the onset of
mood symptoms with the onset of menstrual cycling. In all these conditions, are
working presumption is that shifting levels of such hormones is associated with
a worsening of underlying mood syndromes, and it strongly appears that bipolar
disorder is more likely to be destabilized in this way than unipolar major
depression.

And so, can
taking 240 mgs of Andriol affect mood? To summarize, I would say that from my
experience, and based on this quick literature review, a beneficial effect is
possible, and a negative effect is also possible. We don't have the numbers to
quantify how possible those outcomes are.

Mind you,
don't stop it on the basis of my comments here. You take this information and
discuss it with your physician, of course. Either way, I hope you get a good
outcome --